Evaluation of serial casting to correct equinovarus deformity of the ankle after acquired brain injury in adults

被引:21
作者
Singer, BJ
Jegasothy, GM
Singer, KP
Allison, GT
机构
[1] Univ Western Australia, Dept Surg, Ctr Musculoskeletal Studies, Perth, WA 6000, Australia
[2] Royal Perth Hosp, Dept Physiotherapy, Perth, WA 6001, Australia
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2003年 / 84卷 / 04期
关键词
ankle; brain injuries; casts; surgical; equinovarus; rehabilitation;
D O I
10.1053/apmr.2003.50041
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objective: To determine the potential short-term benefit of serial plaster casting in the management of equinovarus deformity associated with acquired brain injury. Design: Prospective uncontrolled interventional trial. Setting: Inpatient rehabilitation facility in Australia. Participants: Sixteen patients (19 limbs) with equinovarus deformity or deteriorating ankle range of motion associated with severe plantarflexor and invertor muscle overactivity underwent serial plaster casting over an 18-month period. Interventions: Below-knee plaster casts were reapplied weekly to increase joint range and muscle extensibility. Main Outcome Measures: Precasting goniometric measures of maximal ankle dorsiflexion range (in knee extension and flexion) were compared with 4 subsequent test occasions (after initial cast, midpoint of casting, after final cast, 1 wk after removal). The amount and type of assistance required to perform a standardized wheelchair-to-bed transfer before and 3 months from commencement of casting were also compared. Results: Subjects who underwent the serial casting regimen had significantly improved ankle range (knee flexed mean, 18degrees; knee extended mean, 16degrees; P<.0001); 13 subjects reduced their need for transfer assistance (P<0015). Conclusion: Serial casting appears to be effective, at least in the short term, in reducing the equinovarus deformity that occurs after acquired brain injury. Greater ankle mobility was associated with improved transfer independence in the majority of subjects.
引用
收藏
页码:483 / 491
页数:9
相关论文
共 57 条
[1]  
Ada L, 1980, Aust J Physiother, V26, P57, DOI 10.1016/S0004-9514(14)60801-1
[2]  
Ada L, 1988, AUSTR J PHYSIOTHERAP, V34, P260
[3]  
Ada L, 1990, KEY ISSUES NEUROLOGI, P249
[4]  
Ada L., 1990, KEY ISSUES NEUROLOGI, P219
[5]  
[Anonymous], 1999, Physiotherapy
[6]   REDUCTION OF HYPERTONICITY BY EARLY CASTING IN A COMATOSE HEAD-INJURED INDIVIDUAL - A CASE-REPORT [J].
BARNARD, P ;
DILL, H ;
ELDREDGE, P ;
HELD, JM ;
JUDD, DLM ;
NALETTE, E .
PHYSICAL THERAPY, 1984, 64 (10) :1540-1542
[7]   SERIAL CASTING FOR THE MANAGEMENT OF SPASTICITY IN THE HEAD-INJURED ADULT [J].
BOOTH, BJ ;
DOYLE, M ;
MONTGOMERY, J .
PHYSICAL THERAPY, 1983, 63 (12) :1960-1966
[8]  
BOYD RN, 1999, EUROPEAN J NEUROLO S, V6, pS1
[9]   Application of passive stretch and its implications for muscle fibers [J].
De Deyne, PG .
PHYSICAL THERAPY, 2001, 81 (02) :819-827
[10]   Soleus neurotomy for treatment of the spastic equinus foot [J].
Decq, P ;
Filipetti, P ;
Cubillos, A ;
Slavov, V ;
Lefaucheur, JP ;
Nguyen, JP .
NEUROSURGERY, 2000, 47 (05) :1154-1160